Provider Demographics
NPI:1649283367
Name:IRONS, MARTIN JOSEPH (BPHARM, CDE)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:JOSEPH
Last Name:IRONS
Suffix:
Gender:M
Credentials:BPHARM, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:FAIR HAVEN
Mailing Address - State:VT
Mailing Address - Zip Code:05701-1041
Mailing Address - Country:US
Mailing Address - Phone:914-443-4259
Mailing Address - Fax:
Practice Address - Street 1:62 WOODSTOCK AVENUE
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701
Practice Address - Country:US
Practice Address - Phone:802-775-4321
Practice Address - Fax:802-775-8211
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033-0003209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist